BACKGROUND: Three local anesthetics are commonly used for digital nerve block: 2% lidocaine with 1:100,000 epinephrine, 2% lidocaine, and 0.5% bupivacaine. The authors have not identified a study that has compared these three agents in digital nerve block in a randomized fashion. The goal of this study was to determine which of the three agents provided the longest duration of digital nerve blockade. METHODS:Thirty volunteers had the long finger of each hand along with one of their small fingers anesthetized with one of the above agents, respectively. The local anesthetic agent to be used in each finger was randomized. A double-blind design was used. Volunteers reported the time that each of their fingers returned to normal sensation at the tip. An analysis of variance was used to detect significant differences among the three groups, and subsequent pair-wise comparisons were performed using post hoc Tukey tests. RESULTS: The mean duration of anesthesia was as follows: 0.5% bupivacaine, 24.9 hours; 2% lidocaine with epinephrine (1:100,000), 10.4 hours; and 2% lidocaine, 4.9 hours. In both the Bonferroni and Tukey tests, all three agents provided significantly different durations of digital nerve blockade (p = 0.01). CONCLUSIONS: At an average of 24.9 hours, bupivacaine (0.5%) provides a significantly longer digital anesthesia time than the average 10.4 hours achieved by 2% lidocaine with epinephrine (1:100,000), which in turn provides twice as long an anesthesia time as 2% lidocaine (average, 4.9 hours).
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BACKGROUND: Three local anesthetics are commonly used for digital nerve block: 2% lidocaine with 1:100,000 epinephrine, 2% lidocaine, and 0.5% bupivacaine. The authors have not identified a study that has compared these three agents in digital nerve block in a randomized fashion. The goal of this study was to determine which of the three agents provided the longest duration of digital nerve blockade. METHODS: Thirty volunteers had the long finger of each hand along with one of their small fingers anesthetized with one of the above agents, respectively. The local anesthetic agent to be used in each finger was randomized. A double-blind design was used. Volunteers reported the time that each of their fingers returned to normal sensation at the tip. An analysis of variance was used to detect significant differences among the three groups, and subsequent pair-wise comparisons were performed using post hoc Tukey tests. RESULTS: The mean duration of anesthesia was as follows: 0.5% bupivacaine, 24.9 hours; 2% lidocaine with epinephrine (1:100,000), 10.4 hours; and 2% lidocaine, 4.9 hours. In both the Bonferroni and Tukey tests, all three agents provided significantly different durations of digital nerve blockade (p = 0.01). CONCLUSIONS: At an average of 24.9 hours, bupivacaine (0.5%) provides a significantly longer digital anesthesia time than the average 10.4 hours achieved by 2% lidocaine with epinephrine (1:100,000), which in turn provides twice as long an anesthesia time as 2% lidocaine (average, 4.9 hours).
Authors: Constantinos Ketonis; Nayoung Kim; Frederic Liss; Benjamin Zmistowski; Jonas Matzon; Charles Leinberry; Mark Wang; Christopher Jones; Jack Abboudi; William Kirkpatrick; Asif M Ilyas Journal: Hand (N Y) Date: 2016-03-08
Authors: Andrea Poggetti; Anna Maria Nucci; Thomas Giesen; Maurizio Calcagni; Stefano Marchetti; Michele Lisanti Journal: J Hand Microsurg Date: 2018-03-20
Authors: Tiffany Y Borbón; Pingping Qu; T Tausala Coleman-Satterfield; Ryan Kearney; Eileen J Klein Journal: J Am Coll Emerg Physicians Open Date: 2022-07-01
Authors: Beom Suk Kim; Kyungho Kim; Jonathan Day; Jesse Seilern Und Aspang; Jaeyoung Kim Journal: Int J Environ Res Public Health Date: 2021-05-11 Impact factor: 3.390